How does an unplanned home birth work?

(59 Posts)

I have booked a hospital birth in UCH, if everything goes right I'm going to the birth centre to have my baby in a few weeks.

However, my doula is a bit concerned that I may birth too quickly, as first labour was 7 hours from the time I got to hospital (about 11 hours from first very weak contractions). I'm in London, so depending on the time of the day there will be traffic to the hospital.

Yesterday I was alone at home with DS (DH was at work, not answering his phone) and thought: if labour started now I wouldn't have anyone to leave DS with - what would I do? And then figured out I would just have stayed home.

I believe if you are giving birth at home you have to call an ambulance and the paramedics would come, is that right? And then?

In my first birth all the midwives did was break my waters without asking for permission and forcing me to push lying on my back. In other words, I would have been better without them at all. I want health professionals around just in case something unexpected happens, and it seems that paramedics would fill this role perfectly well (hopefully nothing will go wrong and they won't even need to come near me).

What I'm asking is: am I deluded or does my reasoning make sense?

PS: Just to make it clear. I'm NOT PLANNING not to go to hospital. It's just that if things go too fast, if I feel I can't go there in time, or if labour starts at 8am (a horrible time to go to Central London), I want to know what my options are.

PS2: Before you ask 'Why don't you book a homebirth and then decide on the day?' The answer: I'm not booking a home birth because I live outside the area of the hospital I'm booking in, and I don't want to book it with the local team of MWs of the local hospital.

Just one more question: do paramedics, by any chance, have gas and air with the? smile

Grumpla Thu 04-Oct-12 09:53:03

I've had two planned home births. They were both great, largely due to the fact that I was supported throughout by calm, confident, pro-homebirth NHS midwives.

Paramedics have far less experience delivering babies, they will NOT want to deliver yours, they will NOT want to be there for hours supporting you through labour. They will presumably put an enormous amount of pressure on you to transfer in to hospital (possibly very late in labour - strapped on your back to a stretcher btw)

I actually think you're being pretty selfish potentially tying up an emergency service. What's wrong with registering for a home birth and deciding on the day?!? What about all the people out there waiting for an ambulance to deal with heart attacks, car crashes, choking etc? You think they should wait (and possibly die as a result?) because you want to have a baby at home but don't want to engage with the services that support that?

I can only assume you really haven't thought this through.

If you need a better birth partner, pay for a private doula or whatever. Write a better birth plan. Go private. There are lots of other options open to you that don't involve wasting time, money and potentially lives.

clareabelle Thu 04-Oct-12 09:54:40

I had an unplanned home birth (first labour was long so when my second labour was not that painful I presumed I had a long time to go, then suddenly my waters went and the baby popped out, my husband called 999 but they arrived after the event! They were lovely and most disappointed not to have delivered him, although my husband still dines out on the story!) but to get back to point, yes they did have gas and air. Even though there was no emergency and it was 5am on a Sunday they blue lighted me to hospital and I had gas and air because delivering the placenta was much more painful!

Hope that helps a bit!

Shagmundfreud Thu 04-Oct-12 09:55:47

Right - if you find yourself alone and in strong labour you phone 999 and leave front door on latch so the paramedics can get in.

If you are pushing hard when they arrive they probably won't put you in ambulance. They will call for a midwife.

You turn the heating up high. You turn a fan heater on if you've got one. This is probably the most important thing you can do for you and your baby, other than phoning for an ambulance.

Grab as many towels as you can. Make sure one is dry to put over you and baby. When baby is born put him or her on your bare chest or stomach and rub with a towel. Then wait for the paramedics to arrive.

Most full term babies born before arrival end up in SCBU because they've become chilled.

Hope you don't need to do any of this! (I'm sure you won't!)

Grumpla Thu 04-Oct-12 09:59:06

Having re-read your original post I appear to have gone off on the deep end slightly, sorry.

Is the main issue not that you don't want midwives but that you don't have childcare?

That is quite a common problem, may e try and have two or three different people on "standby" to come and look after DC? What about nursery? Mine said if it was an emergency they could take Ds1 for a few hours whilst my inlaws travelled to pick him up, if I went into labour on a day when he wasn't booked in.

Grumpy Grumpla, I think you should read my OP properly before bashing me. I'm not planning on doing that and I answered all the questions you asked in your diatribe. Thanks for the few useful information though.

Clareabelle, I was thinking exactly what would happen in a situation like that. If things build up in a clear pattern like the first time, I won't have any problem going to hospital. I just wonder about things like what happened to you. And it's good to know they have gas and air! smile (although I agree with the grumpy poster that it's not fair to keep the paramedics with me for too long, so won't be able to use the gas that much)

Hi Grumpla, thanks for your second message smile

I have no family around, but my mum is coming over (all family lives oversea) nearer the due date. Hopefully I will have childcare. It will be a problem only if baby comes too early.

I'm just trying to gather information in case I have a situation like the one Clareabelle described AND baby comes before my mum is around. It's all very unlikely to happen.

I have a doula, a birth plan and I have changed hospitals and am so far pretty satisfied with the new one. So, chances are that everything will work well in a hospital birth centre birth.

Shagmundfreud Thu 04-Oct-12 10:08:25

Grumpla, don't be so harsh.

The OP is worrying about having a precipitate labour. It does happen. Frequently.

I have a friend who's an experienced paramedic and the majority of their 'wasting time' calls related to labour are from women in the early stages of labour who simply don't want to pay for a taxi, so phone for a 'materna-taxi' (lol) ie, an ambulance.

If the OP finds herself alone and in suddenly in strong labour it would be perfectly reasonable to phone for an ambulance.

The OP isn't suggesting having paramedics hanging around for hours while she labours. They wouldn't do this anyway! Unless she was incredibly close to delivering they would take her to hospital.

TittyWhistles Thu 04-Oct-12 10:18:22

I always thought it would be lovely to 'accidentally' give birth at home, without fuss or intervention, But the reality is that there are more likely to be complications if you don't have the guidance of a midwife, even if you might think you're better off without them hmm.

Paramedics are not specialists in obstetrics and might never have delivered a baby before. Its wrong to rely on paramedics who are not immune from getting caught in traffic. I also agree its rather selfish to 'plan' (even plan B) for this to happen as 999 is for emergencies.

On the upside, a 7 hour labour first time doesn't mean it'll be quicker second time. I think you'll have plenty of time because you'll know the signs of labour better than you did first time round.

Shagmundfreud Thu 04-Oct-12 10:26:53

"But the reality is that there are more likely to be complications if you don't have the guidance of a midwife"

Actually, if you look at the research into 'born before arrival', when it comes to babies born at term to healthy mothers following precipitate labours, births tend to me MORE straightforward, not less, than births which happen with a health professional present. The whole point of full-term BBA's is that these are mothers whose bodies labour extremely efficiently. For these women there is almost nothing that a midwife can do that will make their labour easier! There was a recent small study looking at all the BBA's in one area - to healthy mums and to mums with serious health problems. Overall the women came out of the experience amazingly well. I'll see if I can dig it out.

Of course if things do go wrong it can be catastrophic, which is why it's best to have a midwife present.smile

cooper44 Thu 04-Oct-12 10:30:21

hi there - sounds like you have a couple of very informative responses already but just thought I would add......with DS1 I laboured at home from Monday AM until Tuesday evening when everything suddenly slowed down. I then woke up late that night and was ready to push - there was no way DH or the doula could move me because I knew the baby was about to appear. We called the midwives but they wouldn't send anyone without sending an ambulance out first. (this is also in central London) When the paramedics arrived they then called the midwife who arrived pronto and set everything up for delivery. Was 10cm ready to push but my son then got stuck. They tried everything they could at home but then had to be transferred to hospital anyway. There was no gas and air on offer from either paramedics or midwife.....although am sure they probably carry it. in terms of paramedics delivering I can't imagine the ones we had doing it. No offence - am big fan of the NHS but they chucked a pack with towels and stuff at the doula as though she might be able to deliver. Then sat in the living room chatting until the brilliant midwife arrived at which point I felt far far more calm and reassured.

Rolf Thu 04-Oct-12 10:33:02

I had an accidental home birth with DC4. I laboured very quickly and by the time I realised that I wasn't having Braxton Hicks (which I'd had, strongly, for weeks) I was in the 2nd stage of labour.

You've had really good advice earlier in the thread: make sure paramedics can get into the house whilst keeping your DS safe. When this happened to a friend she managed to get DC1 safely watching a DVD whilst she laboured in the hall. Make sure the baby won't get cold. Leave the cord alone. Keep a charged-up phone on you at all times. And have as many people on standby as you can manage. If you keep sitting on the loo because you need a poo - it's probably the baby so get off the loo grin

In my case, the midwives arrived a few minutes before the baby was born but they asked DH to dial 999 as the baby had turned round at the last minute and was breech. The things they told DH to do were to turn the heating up high and get lots of towels and a hot water bottle. Everything was fine - lovely in fact - but I was lucky that the midwife was local, otherwise I'd have had no assistance. The paramedics arrived after the baby was born.

Good luck smile

plonko Thu 04-Oct-12 10:34:04

I was asking my mum about this just yesterday as I was born in similar circumstances. My parents lived in Nottingham but dad was working in Birmingham, mum was at home with my sister who was 4 years old. Mobiles didn't exist.

She went into labour at 8 am, shortly after he left for work. Her first labour was very quick, less than three hours. Midwife arrived and asked my sister to go and pick flowers from the garden for the new baby. I was born at 10.30, dad got home at 11am. Mum had gas and air. She said it was the best experience of her life (but then what else would I expect?!), far better than the hospital experience she'd had with my sister, rather more calm and relaxing. Dad preoccupied my sister while the midwife helped clean up.

At no point were emergency services mentioned. I think if the same happened to me I'd follow exactly the same pattern - call the community midwife, wait for someone to show up, try to cope on my own until then. I wouldn't call 999 unless I was panicking, because I think midwives would have a much more calming effect in that situation. I just hope I've inherited my mum's ability to have sneeze births with no pain relief! smile

Shagmundfreud Thu 04-Oct-12 10:44:58

"Midwife arrived and asked my sister to go and pick flowers from the garden for the new baby."

Superb! smile

TittyWhistles Thu 04-Oct-12 10:47:10

shag. That's really interesting, still, I'd rather have a midwife present than a paramedic (no offence to paramedics of course!)

Perhaps the best person for you to call on shroedinger in a crisis is your Doula, she's the one who has prompted this thread and your worries after all.

Hi OP, I know this has nothing to do with your questions but I was just wondering, you said you transferred hospitals? How would I go about doing this? I am not happy with my hospital in this pregnancy or my previous 2 and I didn't know I had another option. Could I choose any hospital I want? Within reason obviously lol

Many thanks for all the answers.

Plonko, your birth sounds lovely! That's what every homebirther dreams to have.

Very good points to keep in mind. First and more important: paramedics are nort experts in childbirth (I forgot that, although it's so obvious) and they don't have hours to waste with me.

I'm a bit shock that someone would call 999 to get a free ride to hospital!

Titty, as I said, if labour progresses like the last time, I'll get to hospital just fine, as things built up gradually and steadily, and this time I know better how it works (I mean, if it goes the same way).

And the thread was not prompted by the doula. I had already read some second birth stories in MN that got me thinking about that.

Anyway. Positive thinking: baby will come at 40 weeks, my mum will be here, I'll go to hospital, everything will be quick and I'll be back home a few hours later. And I'll go to hospital in the middle of the night, like with DS1, so no traffic (and DH will be home when it starts). [hopeful emoticon] smile

TheMan, as far as I know you can choose any hospital (but it wouldn't be wise to choose one that is at the other side of London, unless you're having an ELCS!).

In my case I had my first at Royal Free and didn't like it. Then in my first consultation with the GP in this pregnancy (they demand that the GP refers you to midwife care in my surgery, I don't know if it's the same everywhere) I asked to be referred to the Whittington. They booked me in.

Didn't like it, so decided to go to UCH, as these are the three options in the area. I went on the website and found out I just needed to self refer. So I got a form, filled it and send them, and then they arranged a new booking appointment. It was very straightforward.

CaptainVonTrapp Thu 04-Oct-12 11:04:51

I know 3 people who have had this happen. Paramedics arrived first and the 999 operator contacted the community midwife who arrived shortly afterwards. Midwife delivered one, paramedics another and husband another. One Mum went to hospital to have a bad tear repaired. The others all stayed at home. Babies were all fine and none ended up in hospital. 999 operator gave instructions over phone to husband on how to catch baby and make sure the cord wasn't wrapped around its neck.

Startailoforangeandgold Thu 04-Oct-12 11:06:17

Heating to max. That was the only problem we had with our planned HB. We had to dry DD2 with the hair dryer and wrap her up very well.

What's comfy for adults is to cool for wet newborns.

TunipTheVegemal Thu 04-Oct-12 11:13:40

I had one with dc3. Hospital sent me home despite my saying how quickly dc2 had arrived. 'What if I can't get back here in time?' I say. They reply airily 'Oh, just call an ambulance.'

The ambulance was busy and couldn't get here for 45 minutes so DH was on the end of the phone to them fulling expecting he'd have to catch the baby. Finally paramedics appeared - my abiding memory is of labouring on hands and knees on the living room floor and seeing these two pairs of big boots come into the room and looking up and being chuffed to bits to find that both paramedics were young women smile. They had gas & air. They asked me if I wanted to try to get into the ambulance and make a run for it, I said yes (God knows why!), climbed into ambulance and out popped ds2.

Whole thing was observed by roofers sitting on scaffolding mending nextdoor's roof.

The midwife got there in time for the third stage. She then decided we should go to hospital to be checked over.

The next day I was doing the school run (dd had just started school a few weeks earlier) and one of the roofers turns out to be the dad of someone in dd's class, he's describing the scene to the other mums - 'Er, that was me!' I say, pointing to the baby in my sling.

Definitely my favourite birth - I count myself lucky the way it turned out.

notso Thu 04-Oct-12 11:25:20

I had DC4 at home unplanned 6 months ago and it was fucking scary.
Phoned labour ward and told them I was in intense pain every ten mins and third labour was v. quick only just made it to the hospital felt exactly the same, was told not to go into labour ward until contractions were every three mins, and surely by DC4 I should know what labour was like.
Less than 15 mins after the phone call, DH delivered the head guided by 999 operater and paramedic delivered the body, the contractions never got closer together.
The first response paramedic didn't have gas and air, the ambulance ones did but they arrived too late.
I had to go to hospital to deliver the placenta as the paramedics didn't carry the injection to assist it. I had to walk to the ambulance wearing only a blanket, holding the cord and dripping blood everywhere, I was in total shock, I couldnt hold DS for ages as I was shaking too much. He did end up in SCUBU and childrens ward for refusal to feed potentialy due to infection.
Poor DH had to go home and clean up the mess which looked like a crime scene, I lost a lot of blood.
I still feel panicky when I go into the room he was born in.

Willabywallaby Thu 04-Oct-12 11:26:07

I had an unplanned home birth. Luckily I had spoken to the midwife and she was on her way, but don't think she realised what the traffic would be like. Husband works in our house so I shouted for him and he delivery DS2 with a midwife on the phone, the one that was on her way gave me her number and she called the unit who called us.

It was much nicer than going to hospital. Shame you can't have a planned home birth.

Would your DS be ok with a DVD if it all kicks off when he's home?

Our DS1 was at nursery that day (the walk probably helped things along). Whatever happens good luck x

TunipTheVegemal Thu 04-Oct-12 11:28:27

Notso, that's appalling from start to finish. I'm so sorry you were looked after so badly. xx

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